Dr. L. Ebony Boulware is a junior faculty member in the Department of Medicine and the Welch Center for Prevention, Epidemiology and Clinical Research at the Johns Hopkins School of Medicine who recently trained in Internal Medicine at University of Maryland Medical Center and completed a fellowship in General Internal Medicine at Johns Hopkins. She seeks this Mentored Clinical Scientist Award to study why the health burden of CKD is magnified among ethnic/racial minorities. Ethnic/racial disparities in the incidence and prevalence of CKD are striking, with African Americans suffering rates of CKD 4 to 6 times greater than their White counterparts. While some of the excess incidence of ESRD in high-risk populations can be explained by sociodemographic, lifestyle, and clinical factors, much of the excess risk of progression toward ESRD for ethnic minorities remains unexplained. Building on research experience and skills attained during her fellowship, Dr. Boulware aims to assess potential attitudinal, behavioral, and clinical mechanisms (awareness and perceived susceptibility to disease, adherence, trust and perceived discrimination, patient-physician communication) through which previously unexplained ethnic/racial disparities in CKD could be explained. She will conduct cross-sectional and longitudinal studies of participants in a multi-center study (Atherosclerosis Risk in Communities Study), high-risk African Americans (Jackson Heart Study), and high-risk patients in urban clinical settings (collecting data in her proposed ancillary study to an ongoing NIH/NHLBI-funded randomized controlled trial of persons with hypertension and diabetes in Maryland). Data include medical history, behavioral measures, physical examination measures, and laboratory studies. Analytic methods will include logistic regression, survival analysis, analysis of clustered data, and other longitudinal data analysis techniques. In addition to experience in the conduct of these studies, Dr. Boulware will enhance her research knowledge and skills through advanced coursework, research team meetings, conferences, and seminars in the supportive and multidisciplinary environment of the Welch Center. This award will provide Dr. Boulware with a foundation to launch her independent research career devoted to understanding the reasons behind ethnic/racial disparities in chronic kidney disease (CKD) progression, and in reducing ethnic/racial disparities in CKD.